Contraceptive Coverage in the Health Care Law: What Happens on August 1, 2012?

07.30.12 -

Our partners at the National Women's Law Center have graciously let us share this Fact Sheet with you. Please visit their website for more details on contraceptive coverage.

On August 1, 2012, provisions in the health care law requiring insurance companies to cover contraceptives with no co-pay will go into effect. In the next few years, as an increasing number of health plans come under the law's reach, more and more women will have access to all of the FDA-approved forms of contraception with no co-pay. This means that eventually all women with private insurance will get the full range of FDA-approved birth control methods, including oral contraception (the pill), injectables, the ring, contraceptive implants, diaphragms, cervical caps, and non-surgical permanent contraceptives without paying a co-payment or having the costs applied to her deductible. Sterilization for women is also covered with no co-pay or deductible.

Does this mean that I will have access to birth control with no co-pay on August 1, 2012?

The August 1st implementation date means that "new" private health insurance plans must include this coverage at the start of their next plan year on or
after August 1st. Your access to this coverage will depend on when your plan's new year begins.

Most private insurance plan years begin on January 1, so they will be required to offer this coverage as of January 1, 2013. However, some plans must
begin offering this new benefit immediately. For example, school health plans, which often begin their health plan years around the beginning of the school
year, will see the benefits on the August 1st start date. (Please note, many private insurance plans started providing some of the preventive services in advance of their new plan year—so you may already be covered.)

I heard that some plans do not have to cover this benefit on August 1 because they are "grandfathered" and not "new." What does this mean?

Health plans that existed before the health care law are considered "grandfathered" and do not have to follow the preventive services cost sharing
rules. This means that the plan can continue to operate as it has until it makes significant changes.

Will my plan ever become "un-grandfathered" and have to follow the new rule?

Yes. A recent survey found that 90% of all large U.S. companies expect that their health plans will lose grandfathered status by 2014. Eventually all
plans will lose their grandfathered status and distinctions between the two types of plans will disappear. At that point, all plans will cover
contraception without a co-pay.

What if I work for a church or another religious employer?

A segment of religious employers, such as churches and other houses of worship, are exempt from this contraceptive coverage requirement. The
Administration has proposed an "accommodation" for other, undefined "religious organizations" that allows them to avoid providing contraceptive coverage
directly, but ensures that the women who work for them still receive contraceptive coverage without a co-pay. For more information on this proposed
accommodation, please see our fact sheet Contraceptive Coverage "Accommodation" of Other "Religious Organizations": Frequently Asked Questions.

What if I am a student and enrolled in a student health plan?

The new contraceptive coverage requirement applies to student health plans as well, except those that are self-funded.

Won't this make my monthly premiums go up?

While we can't say for certain, there is strong evidence that covering contraceptives actually produces cost savings, because maternity, infant, and
dependent care are more expensive than family planning services. According to the National Business Group on Health (NBGH), a non-profit organization
representing employers' perspectives on national health policy issues, the cost of adding contraceptive coverage without co-pay to a health plan is more
than made up for in expected cost savings. And when contraceptive coverage was added to the federal employee plan, premiums did not increase because
there was no resulting health care cost increase.

Also, if you think you have been denied coverage, have questions or want to share your story, please call us at 1-866-PILL4US or email us at pill4us@nwlc.org. Our experts here at the National Women's Law Center are happy to help you in any way that we can.